Date of Award

Spring 5-4-2018

Document Type

DNP Project

Project Team Faculty Member

Kay Gaehle

Project Team Faculty Member

Debra Jenkins


heart failure, home health, 30-day readmission, nurse education, patient education


Heart failure is a common diagnosis that affects millions of people worldwide. Unfortunately, heart failure is associated with a high risk of 30-day hospital readmission rates. Home health nurses have the potential to bridge the gap between discharge and hospital readmission by providing up-to-date patient education on a one-to-one basis. Research indicates home health nurses lack knowledge of the disease process, nurse management of the disease, and treatment. This project focused on an educational session about the pathophysiology of heart failure, fluid/weight monitoring, diet, medications, and exercise with a pre- and post-tests evaluating home health nurses understanding of heart failure. This intervention provided educational opportunities to improve the patient’s understanding of their heart failure diagnosis, self-management of the disease process, and provide guidelines for notifying the nurse of a change in their condition with the use of a heart failure zone tool. This project revealed that in this small setting that home health nurses play a pivotal role in reducing 30-day readmission rates by increasing their heart failure knowledge and providing personal education sessions for heart failure patients.

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Nursing Commons



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